Background and Purpose A large community hospital implemented an acute stroke program to respond to stroke patients in a consistent, systematic, and efficient manner.
The primary objectives were to monitor the care delivered, improve the quality of care, and move the patients through their initial hospital stay in a timely manner.
Methods Acute stroke standing orders were developed, with a critical path developed on the basis of these orders and an expected length of stay.
A multidisciplinary team began the rehabilitation process early in the hospital stay, monitored patient progress and length of stay, and provided appropriate discharge placement.
Retrospective chart reviews were performed over a 4-year period, and the data were collated on a yearly basis.
Results Over a 4-year period, 414 Medicare patients demonstrated a steady decline of initial hospital length of stay from 7.0 to 4.6 days.
During this same period of time, there was a decline in total hospital charges from $14 076 to $10 740 per patient.
This represented a total dollar savings in charges of $1 621 296 ($453 000 per year).
The mortality rate for 1994 was 4.6%, with 46.5% of survivors discharged to home, 16.9% to acute rehabilitation, and 32.6% to nursing homes.
Conclusions The implementation of a multidisciplinary acute stroke program decreased length of stay and hospitalization costs of Medicare patients.
Mots-clés Pascal : Accident cérébrovasculaire, Hospitalisation, Coût, Analyse coût, Implémentation, Plan traitement, Etats Unis, Amérique du Nord, Amérique, Durée, Homme, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Cérébrovasculaire pathologie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Economie santé
Mots-clés Pascal anglais : Stroke, Hospitalization, Costs, Cost analysis, Implementation, Treatment planning, United States, North America, America, Duration, Human, Nervous system diseases, Central nervous system disease, Cerebral disorder, Cerebrovascular disease, Cardiovascular disease, Vascular disease, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0288968
Code Inist : 002B17C. Création : 199608.